Published
in the June 18 issue of the North America British Medical Journal, the
study found that “planned home births for low risk women in the United
States are associated with similar safety and less medical intervention
as low risk hospital births” according to the BMJ press release (see
below).

Co-author Ken Johnson has stated that this is the largest study of its kind at this time.The
study is prospective (initial data submitted before the birth took
place, so no births could be “left out”) and includes data from more
than 5000 births in the U.S and Canada.This study cannot be written off for being too small or not relevant to US populations and circumstances.

The
BMJ also has a “rapid response” feature, where readers can post letters
about articles (comments, responses, etc.). As the BMJ states:“Think of Rapid Responses as electronic letters to the editor.”On the BMJ home page www.bmj.com
find “Interactions” in the menu list on the left, and choose “Rapid
Responses” for more information. CfM is posting a rapid response
shortly.

Would
you like to see your local newspaper report about this study? The BMJ
will have posted their press release to wire services, but this study
may not be considered hot news by very many newspapers.However,
midwifery advocates all over the country can help get news attention on
this study, especially if your state is working on midwifery
legislation. You may even be able to use this study as a way to bring a fledgling group and its work to positive public attention.The
best situation is when someone already has a relationship with a news
reporter at your local newspaper (you have talked with them before, you
have given them any news tips, etc.). Call up your contact and talk
with them about this study and its relevance in your community, offer
them the BMJ press release (see below) and additional information from
author Betty-Anne Daviss (see below).If
you have a local birth network or birth-related advocacy group of any
kind, make sure to let the reporter know how the study is relevant to
your group and what it is doing. If you don’t already have a contact at
your local paper, you could use this study as a reason to pick up the
phone and begin a relationship.

When
you read the study (it is not difficult to understand), you will find
many points that can be made; here are a few to start with:

The
study demonstrates unequivocally that for “low risk” mothers, home
birth attended by a CPM results in outcomes comparable to low risk
births in the hospital – ie CPM-attended planned home births are safe
for mothers and babies.

Despite
the fact that the midwives in the study included many who were not
well-integrated into the health care system, mothers and babies that
did need medical attention were appropriately identified and
transported to hospitals and got the care they needed; otherwise, we
would not see the good outcomes that are comparable to hospital birth
outcomes.

Substantially
fewer interventions were performed on mothers planning home births than
on comparable mothers giving birth in hospitals, which suggests that
many of those interventions are unnecessary. Such unnecessary
interventions are costly and are associated with increased
complications for mothers and babies.

Overall,
the study shows that for healthy women, a planned home birth with a
trained midwife (ie, a CPM), is a safe and reasonable choice for
maternity care, supported by the evidence.If maternity care is “scientific” women everywhere should have access to midwives and out-of-hospital birth.

=======================================

Press Release from BMJ

Planned home births in the United States are safe, say researchers.

Outcomes
of planned home births with certified professional midwives: large
prospective study in North America BMJ Volume 330, pp [to be added]

Planned home births for low risk women in the United States are associated with similar safety and less medical intervention as low risk hospital births, finds a study in this week's BMJ.

Midwives involved with home births are often not well integrated into the healthcare system in the United States and evidence on the safety of such home births is limited.

In
the largest study of its kind internationally to date, researchers
analysed over 5000 home births involving certified professional
midwives across the United States and Canada in 2000. Outcomes and medical interventions were compared with those of low risk hospital births.

Rates
of medical intervention, such as epidural, forceps and caesarean
section, were lower for planned home births than for low risk hospital
births. Planned home births also had a low mortality rate during labour
and delivery, similar to that in most studies of low risk hospital
births in North America.

A
high degree of safety and maternal satisfaction were reported, and over
87% of mothers and babies did not require transfer to hospital.

"Our
study of certified professional midwives suggests that they achieve
good outcomes among low risk women without routine use of expensive
hospital interventions," say the authors. "This evidence supports the
American Public Health Association's recommendation to increase access
to out of hospital maternity care services with direct entry midwives
in the United States."